Smoking and pancreatic disease

Yadav D, Hawes RH, Brand RE, et al. Alcohol consumption, cigarette smoking, and the risk of recurrent acute and chronic pancreatitis. Arch Intern Med. 2009 Jun 8; 169(11):1035-45.

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Chronic pancreatitis_smoking

Figure 3. Distribution of self-reported smoking status (A) and amount (B) stratified by drinking categories. All proportions are based on effective numbers, and never smokers account for the proportions not reflected in the graphs. C indicates control group; CP, chronic pancreatitis group; RAP, recurrent acute pancreatitis group.

“Cigarette smoking was more prevalent among CP patients compared to controls and RAP patients (Table 1). The prevalence and amount of smoking (Figure 3a, ​,b)b) increased linearly with the level of drinking in controls and pancreatitis patients. Almost two-thirds of very heavy drinkers and 51.6% heavy drinkers with CP reported smoking ≥1 ppd compared to 13.9% abstainers and 34.3% light drinkers. The amount of smoking was significantly higher in CP patients (26.6 pack years; IQR 12, 46) compared to RAP (19.5; IQR 7.9, 36.1, p=0.001) and controls (16.2; IQR 6, 32.7). CP patients also had significantly longer smoking duration (median 30.5 years; IQR 19.7, 39) than controls (21.9; IQR 11.4, 33.1; p<0.001) and RAP patients (22.7; IQR 12, 32; p<0.001). Duration of smoking for CP patients was significantly longer than controls for all drinking levels except abstainers and light drinkers, and from RAP patients who were light or heavy drinkers.”

Tolstrup JS, et al. Smoking and risk of acute and chronic pancreatitis among women and men: a population-based cohort study. Arch Intern Med. 2009 Mar 23;169(6): 603-9.

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Results: A total of 235 cases of pancreatitis occurred during follow-up. A dose-response association between smoking and risk of acute and chronic pancreatitis was observed in both men and women. For example, the hazard ratio of developing pancreatitis was 2.6 (95% confidence interval [CI], 1.5-4.7) among women and 2.6 (95% CI, 1.1-6.2) among men who smoked 15 to 24 grams of tobacco per day. Alcohol intake was associated with an increased risk of pancreatitis (hazard ratio, 1.09; 95% CI, 1.04-1.14 for each additional drink per day). The risk of pancreatitis associated with smoking, however, was independent of alcohol and gallstone disease. Approximately 46% of cases of pancreatitis were attributable to smoking in this cohort.

Conclusion: In this population of Danish men and women, smoking was independently associated with increased risk of pancreatitis.

Edderkaoui M, Thrower E. Smoking and Pancreatic Disease. J Cancer Ther. 2013 Nov 1;4(10A):34-40.

“Smoking is a risk factor for acute and chronic pancreatitis, and pancreatic cancer. It also increases the risk of pancreatic cancer in patients with pancreatitis. Identification of cellular targets, such as nAChR, will help in development of potential therapies. Furthermore, the use of reliable animal models such as the Pdx1-Cre, LSL-Kras mice will help dissect relevant cellular changes in the pancreas induced by smoking.”

More PubMed results on smoking and pancreatic disease.

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